Watch: How do statins prevent heart attacks and strokes?

Statins reduce your cholesterol levels and lower your risk of heart attack and stroke. They’re one of the best-researched drugs, but also one of the most controversial. Watch our animation all about statins, and see if you can tell statin fact from fiction.

Can you tell statin fact from fiction? Read on to find out...

1. Cholesterol levels can get too low

FICTION

It’s impossible for cholesterol levels to get too low. You may have low cholesterol levels, but your body is still making it. You’ll never “run out” of it. The aim is always to balance your healthy (HDL) and unhealthy (non-HDL) cholesterol. If you stop taking your statin when your cholesterol is at a normal level, your cholesterol could then rise to unhealthy levels again.

An illustration showing plaque build-up in a blood vessel.

2. Avoid grapefruit juice if you’re on statins.

FACT, but it depends which statins you are on.

Some statins react with grapefruit and grapefruit juice, but not all of them.

Do not drink grapefruit juice or eat grapefruit if you’re taking simvastatin.

If you’re taking atorvastatin you can drink grapefruit juice, but not in large quantities (more than 1.2 litres a day – for context, most large cartons of grapefruit juice are 1 litre). The occasional glass of grapefruit juice or half a grapefruit shouldn’t be a problem if you’re taking atorvastatin, but avoid having grapefruit too regularly, as it could increase your risk of side effects.

If you take another type of statin, grapefruit is not thought to be a problem.

3. If you eat healthily you won’t need statins

FICTION

Statins don’t just lower cholesterol levels but also reduce the risk of fatty plaques breaking off from walls of your arteries

Statins don’t just lower cholesterol levels but also reduce the risk of fatty plaques breaking off from walls of your arteries, reducing the risk of heart attack and stroke.

Some people may be able to reduce their cholesterol to safe levels by changing their diet, or exercising more. However others will need a statin alongside a healthy lifestyle. You could eat healthily your whole life (which will benefit your overall health), but your body might still be making too much cholesterol.

An estimated 250,000 people in the UK have familial hypercholesterolemia (FH), which usually means high cholesterol from birth, and though lifestyle changes will help keep them heart healthy it won’t reduce cholesterol enough. Usually, a high-intensity statin such as atorvastatin or rosuvastatin will be needed to bring it down.

4. There is only one statin

FICTION

There are five commonly given statins currently in use in the UK: simvastatin, atorvastatin, rosuvastatin, fluvastatin, and pravastatin.

If low intensity statins (pravastatin, fluvastatin or simvastatin) aren’t working for you, you might need a higher intensity statin (atorvastatin or rosuvastatin), as well as improving your diet and getting active. Similarly the dose of a statin varies from 5mg to 80mg, depending on the statin and the amount you need to reduce your non-HDL (bad) cholesterol.

5. You’ll have bad side effects

FICTION

Side effects are rare. Even one of the more common side effects, muscle pain, is rare. In a typical year, only one in 500 patients would be affected. In very rare cases, people may experience significant muscle pain caused by rhabdomyolysis. If you are getting bad side effects, contact your GP, who can change your statin or dose. Statins are one of the most researched drugs in the UK, and had to be rigorously tested for safety and effectiveness before they were approved.

6. They could increase your risk of diabetes

FACT

Your doctor would weigh up the potential risks and benefits for you before suggesting statins, and should make any risks clear

Research such as this BHF-funded study has found that people who are on statins have a slightly increased risk of developing type-2 diabetes. It is a low chance, and your doctor would weigh up the potential risks and benefits for you before suggesting statins, and should make any risks clear.

The research also highlights that those on the highest doses of statins have the highest risk of developing type-2 diabetes. But people who are prescribed the highest doses are usually those who already have evidence of heart disease, and it is this group that needs the protection of statins most.

While statins may increase the blood sugar level in some people, this does not offset the overall benefit that statins provide. If you take statins, watch your diet and include regular exercise in your routine.

7. Statins are only for people who’ve had a heart attack or stroke already

FICTION

They are commonly prescribed by GPs for people who are at risk of a heart attack or stroke, in order to reduce the risk. If you’ve had a heart attack or stroke you’re taking them to reduce your risk of further events. If you’ve had an angioplasty or coronary artery bypass surgery, this does not mean that you are cured. You will still need to take statins, usually for life.

8. You shouldn’t take statins if you’re over 80

FICTION

Large clinical trials have shown that statins reduce your risk of heart attacks and stroke, whatever your age, and that statins are safe in older age groups. Statin treatments in the over-80s should always be assessed depending on the individual, their lifestyle, life expectancy, and the possible benefit of statins.

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Our statins animation was created with input from our Patient Information Panel. A group of patients were involved at every stage, making suggestions and giving feedback to help us make the animation as useful as possible for everyone.

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British Heart Foundation is a registered Charity No. 225971. Registered as a Company limited by guarantee in England & Wales No. 699547. Registered office at Greater London House, 180 Hampstead Road, London NW1 7AW. Registered as a Charity in Scotland No. SC039426 .